A 7-Year Follow-up of Patellar Tendon and Hamstring Tendon Grafts for Arthroscopic Anterior Cruciate Ligament Reconstruction: Differences and Similarities

• Published in: The American journal of sports medicine 2005-09, Vol.33 (9), p.1337-1345
• Main Authors: Roe, Justin, Pinczewski, Leo A., Russell, Vivianne J., Salmon, Lucy J., Kawamata, Tomomaro, Chew, Melvin
• Format: Article
• Language: English
• Subjects: Anterior cruciate ligament; Anterior Cruciate Ligament - surgery; Anterior Cruciate Ligament Injuries; Arthroscopy; Biological and medical sciences; Bone-Patellar Tendon-Bone Grafting; Endoscopy; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Humans; Injuries; Injuries of the limb. Injuries of the spine; Investigative techniques, diagnostic techniques (general aspects); Knee; Knee Injuries - surgery; Ligaments; Male; Medical sciences; Patellar tendon; Rupture; Skin & tissue grafts; Sports medicine; Tendons; Tendons - transplantation; Transplantation, Autologous; Traumas. Diseases due to physical agents; Treatment Outcome; Vertebrates: body movement. Posture. Locomotion. Flight. Swimming. Physical exercise. Rest. Sports
• ISSN: 0363-5465; 1552-3365
• DOI: 10.1177/0363546504274145

Background For arthroscopic anterior cruciate ligament reconstruction, the most commonly used graft constructs are either the hamstring tendon or patellar tendon. Well-controlled, long-term studies are needed to determine the differences between the 2 materials. Hypothesis There is a difference between hamstring and patellar tendon grafts in the clinical results of anterior cruciate ligament reconstructions at 7 years. Study Design Cohort study; Level of evidence, 2. Methods Two groups of 90 patients each, consecutively treated with hamstring or patellar tendon grafts, were followed and assessed at 1, 2, 5, and 7 years after surgery. Results At the 7-year review, abnormal radiographic findings were seen in 45% (24/53) of the patellar tendon group and in 14% (7/51) of the hamstring tendon group (P = .002). Although there was no significant difference between the groups in extension deficit (P= .22), the percentage of patients with an extension deficit increased significantly in the patellar tendon group from 8% at 1 year to 25% at 7 years (P= .02). No significant change was seen in the hamstring tendon group over time (P= .20). There was no significant difference in laxity between the groups on Lachman (P= .44), pivot-shift (P= .39), or instrumented (P= .44) testing. Graft rupture occurred in 4 patients from the patellar tendon group and in 9 patients from the hamstring tendon group (P= .15). Both autografts gave excellent subjective results, as evidenced by the International Knee Documentation Committee evaluation and Lysholm knee scores at 7 years. Conclusions Both hamstring and patellar tendon grafts provided good subjective outcomes and objective stability at 7 years. No significant differences in the rate of graft rupture or contralateral anterior cruciate ligament rupture were identified. Patients with patellar tendon grafts had a greater prevalence of osteoarthritis at 7 years after surgery; therefore, the authors preferred hamstring tendons as the primary graft choice in anterior cruciate ligament reconstructions.